Diffuse alopecia areata is the least common clinical type of alopecia, and this diffuse form lacks the characteristic hairless patches of alopecia and it begins as diffuse hair loss. Diffuse alopecia areata has been poorly characterized. In 2002, there was a suggestion to define this form of alopecia areata as acute, diffuse and total alopecia of the female scalp (ADTAFS). ADTAFS is characterized by a marked female predominance, tissue eosinophilia and a uniquely short clinical course. We report here on one case of ADTAFS.
Alopecia ; Alopecia Areata ; Eosinophilia ; Female ; Hair ; Humans ; Scalp

BACKGROUND: Mohs micrographic surgery (MMS) is a specialized type of minimal marginal surgery that offers cure rates superior to other options in the treatment of skin cancer. But only a few reports have been published on the long term outcome of MMS in Korean literatures. OBJECTIVE: Our purpose was to report the clinical findings and recurrence rates of all patients with cutaneous malignancy treated with MMS. METHODS: We retrospectively evaluated 123 patients who had been diagnosed with cutaneous malignant tumors and had been treated with MMS and tumor reconstruction. The main outcome measures were patient demographics, duration of tumor, site, preoperative tumor size, method of reconstruction, and recurrence after MMS. RESULTS: The case series comprised 123 patients (51.2% female and 48.8% male) with a mean age of 65.8 years. Most tumors (78.0%) were on the face and 56.6% of all type of skin tumor were located on the left side. The most common skin tumor was basal cell carcinoma (67.5%). The local flap was the most common method to repair surgical defects (49.6%). Recurrence after MMS was diagnosed in 3 of the 123 patients (2.44%). CONCLUSION: MMS may be a safe and satisfactory method for the treatment of cutaneous malignant tumors and the low recurrence rate with MMS emphasizes the importance of margin controlled excision.
Carcinoma, Basal Cell ; Demography ; Female ; Humans ; Mohs Surgery ; Outcome Assessment (Health Care) ; Recurrence ; Retrospective Studies ; Skin ; Skin Neoplasms

An interdigital pilonidal sinus is considered a rare occupational disease related to individuals with short hair. We describe a case of a 44-year-old man who presented with a tender nodule with a purulent discharge in the fourth interdigital web space of the left foot. The biopsy specimen showed a sinus tract surrounded by keratin and squamous epithelium, and the track contained acute and chronic inflammatory cells. The skin lesion was improved with occlusion of the fistula by using 100% bichloracetic acid. We herein report on a rare case of a interdigital pilonidal sinus in the foot, and this occurred with no relation to the patietn's occupation.
Adult ; Biopsy ; Epithelium ; Fistula ; Foot ; Hair ; Humans ; Keratins ; Occupational Diseases ; Occupations ; Pilonidal Sinus ; Skin ; Track and Field

Bee sting therapy is sometimes used for the treatment of chronic recalcitrant neuralgia and arthralgia and chronic eczema in traditional Korean herbal medicine. The stings of many insects are withdrawn after stinging. However, in certain cases, retained sting materials at the treatment site may induce granulomatous inflammation. A 76-year-old man presented with an erythematous plaque containing a central ulcer and granulation tissue after he had undergone bee sting therapy for a palpable subcutaneous nodule in the right axilla area and eczema on the back. The biopsy specimen showed a granulomatous response marked by histiocytes and giant cells surrounding foreign material. Histologic examination of the subcutaneous nodule in the right axilla showed mature fat cells consistent with a lipoma. Thus, we report a rare case of a foreign body granuloma with skin necrosis occurring after bee sting therapy.
Adipocytes ; Aged ; Arthralgia ; Axilla ; Bees ; Biopsy ; Bites and Stings ; Eczema ; Foreign Bodies ; Giant Cells ; Granulation Tissue ; Granuloma, Foreign-Body ; Herbal Medicine ; Histiocytes ; Humans ; Inflammation ; Insects ; Lipoma ; Necrosis ; Neuralgia ; Skin ; Ulcer

Aneurogenic pulmonary edema(NPE) following an aneurysmal subarachnoid hemorrhage(SAH) is a rare but devastating complication. The authors analyzed the clinical characteristics, therapeutic problems and management results from our cases in order to throughly evaluate for future therapeutic guide for such patients. There were seven patients diagnosed as NPE out of 546 patients who were admitted within one day following a SAH(1.3%) during the past 13 years. They were relatively young(average 51.3 years), had poor clinical grades on admission and had large amount of SAH. Hypotension and hypoxia on admission were also characteristics. Good results were obtained in 4 of the 7 patients by rapid correction of hypoxia and hypotension with intubation, mechanical ventilation and with positive end-expiratory pressure, diuretics and hypertensive drugs. We conclude that NPE following SAH may be triggered by an acute rise in intracranial pressure followed by a simultaneous decrease of the function of the heart and lungs. Although the patients had shown fulminant clinical state on admission, we recommend aggressive management of these patients because some of these patients can recover without neurological deficits by an aggressive treatment.
Aneurysm* ; Anoxia ; Diuretics ; Heart ; Humans ; Hypotension ; Intracranial Aneurysm ; Intracranial Pressure ; Intubation ; Lung ; Positive-Pressure Respiration ; Pulmonary Edema* ; Respiration, Artificial ; Subarachnoid Hemorrhage*

BACKGROUND: The potential benefits of a molecular characterization of cancer are clear. Because of this, there is pressing need to perform in vivo imaging of the molecular features of cancer. However, before designing an appropriate molecular targeting technique utiilizing a cancer-related target molecule such as epidermal growth factor receptor (EGFR), it is necessary to characterize the exact expression of the target molecule. OBJECTIVE: The objective of this study was twofold. Our first goal was to characterize the expression of EGFR in skin cancer, and second, to develop nanoparticles conjugated with antibodies, demonstrating their use as optical probes for detecting cancer cells in vitro. METHODS: We performed immunhistochemical analysis of EGFR expression in skin cancer using monoclonal antibodies. Gold nanoparticles were synthesized and allowed to conjugate to anti-EGFR in epithelial cancer tissue. Following an incubabtion period, we recorded surface plasmon resonance images using gold nanoparticles conjugated to anti-EGFR antibodies. RESULTS: Specific membranous binding of EGFR was detected in all of the 10 non-melanoma skin cancers. Surface plasmon resonance images using gold nanoparticles also showed light scattering around tumor cells. CONCLUSION: These ex vivo results demonstrate that optical imaging using gold nanoparticles can allow selective detection of human epithelial cancer cells. Our study demonstrates the potential of gold nanoparticles to target, probe, and illuminate cancer cells making them an effective biomolecular cancer detection tool.
Antibodies ; Antibodies, Monoclonal ; Humans ; Light ; Nanoparticles ; Optical Imaging ; Receptor, Epidermal Growth Factor ; Skin ; Skin Neoplasms ; Surface Plasmon Resonance

In order to find out the effect of blood glucose on the ischemic brain injury, the authors studied the relationship between the blood glucose level and the infarct volume in a focal cerebral ischemia-reperfusion model in a series of 60 adult rats. The experimental animals were divided into 4 groups of 15 rats: rats in group I were allowed free access to food until ischemic insults: rats in group II were fasted for 24 hours prior to ischemic insult: rats in group III were fed but received intraperitoneal injection of 1.7unit/kg of insulin 50 minutes before the onset of ischemia: and rats in group IV were fed and received intraperitoneal injection of 2g/kg of 50% glucose during ischemia. The ischemia was made through unilateral occlusion of the middle cerebral artery(MCA) by inserting a 16mm length of 4-0 nylon surgical thread through the internal carotid artery as well as occlusion of both common carotid arteries(CCA) using nontraumatic aneurysm clips. Reperfusion was induced by pulling the thread that occluded the MCA as well as removing the aneurysm clips from both of the CCAs. Each group was further divided into a(2 hour), b(4 hour), and c(6 hour) subgroups of 5 rats according to the duration of ischemia. All animal were killed 3 hours after reperfusion, and infarct volume determined by triphenyltetrazolium chloride was calculated by a computer image software. The results showed that rats of glucose loaded during ischemia(group IV) developed the highest blood glucose levels during ischemia and post-ischemia and the largest infarct volume among groups. The rats which were fed until ischemic insult(group I) developed higher blood glucose levels and larger infarct volume than those developed in group II and III. The rats of group III developed higher blood glucose levels and larger infarct volume than group II. According to our data, lowering the blood glucose level by fasting or intraperitoneal injection of insulin reduced the infarct volme in model of transient focal cerebral ischemia. These results suggest that maintenance of low level of blood glucose during early phase of cerebral infarction may reduce volume of infarction and neurological sequelae.
Adult ; Aneurysm ; Animals ; Blood Glucose* ; Brain Injuries ; Brain Ischemia ; Carotid Artery, Internal ; Cerebral Infarction ; Fasting ; Glucose ; Humans ; Infarction ; Injections, Intraperitoneal ; Insulin ; Ischemia ; Ischemic Attack, Transient* ; Nylons ; Rats* ; Reperfusion

Purpose: To report the clinical efficacy of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser iris cystotomy in iris cysts. Methods: We examined three eyes with primary iris cysts diagnosed by ultrasound biomicroscopy that had fewer cornea endothelial cells or reduced visual acuity due to an occluded visual axis. Nd:YAG laser cystotomy was done. The logarithm of the minimum angle of resolution (logMAR) visual acuity, intraocular pressure (IOP), and specular microscopy test at baseline and last follow-up were reviewed. Results: The average patient age was 54.0 ± 5.3 years; the mean follow-up was 11.7 ± 2.1 months. The baseline and final logMAR visual acuity were 0.23 ± 0.25 and 0.16 ± 0.15, respectively. Visual acuity improved, although not significantly (p = 0.317). The baseline and final IOP were 14.7 ± 2.3 and 13.7 ± 0.6 mmHg, respectively (p = 0.276). The corneal endothelial cell density (p = 0.109), hexagonality (p > 0.999), and coefficient of variation (p = 0.285) were not significantly different after treatment. There were no serious complications or recurrence. Conclusions After Nd:YAG laser cystotomy, the cell density and morphology of corneal endothelial cells changed little. It can be considered an effective treatment when there is a decrease in corneal endothelial cells or occlusion of the visual axis.

Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare, self-limited lymphadenopathy, typically in young women, that usually remits spontaneously and does not recur. KD is clinically characterized by cervical lymphadenopathy and a high fever. Extranodal involvement (skin, arthritis, meningitis) rarely occurs. When KD is involved in a skin lesion, it presents with various shapes, but rarely manifests with symmetrically distributed, erythematous, firm nodules only on the face. In this report, we describe a patient with KD and unique skin manifestations.
Arthritis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphatic Diseases ; Skin ; Skin Manifestations

Pseudo-inflammatory tumors are also known as plasma cell granuloma, inflammatory pseudo-tumor and inflammatory myofibroblastic tumor, and these tumors are a group of highly variable proliferations of myofibroblastic cells that are associated with a prominent inflammatory infiltrate. This tumor is known to most commonly occur in the lungs, bladder and gastrointestinal system with only a few cases having been reported in the skin. A previously healthy 26-year-old man presented with a 6-year history of an intermittently pruritic lesion on his back. On the histologic examination, there were spindle cells in fascicles and a mixed inflammatory cellular infiltrate of plasma cells and lymphocytes. A diagnosis of inflammatory fibroblastic tumor was made and the nodule was surgically removed. We report here on an additional case of this rare cutaneous entity, and it is probably the first such report from Korea.
Adult ; Fibroblasts ; Granuloma, Plasma Cell ; Humans ; Korea ; Lung ; Lymphocytes ; Myofibroblasts ; Plasma Cells ; Skin ; Urinary Bladder